- Complete High-risk assessment in member's home: Members with diabetes who are poorly controlled, and/or have an existing comorbidity will be priority for timely delivery of services and programs;
- Develop individualized care plans including medical and non-medical activities;
- Provide medication reconciliation and support for medication adherence during care transitions;
- Address potential gaps in meeting the member's interrelated medical, social, developmental, behavioral, educational, informal support system, financial, and spiritual needs in order to achieve optimal health, wellness or end-of-life outcomes, according to member preferences;
- Provide self-management and chronic disease education in appropriate languages and from culturally competent sources;
- Organize and coordinates chronic disease classes for members and support systems;
- Ensure that complex care management activities are effectively coordinated with the member's PCMP and other Medicaid providers to reduce duplication of services;
- Facilitate access to appropriate resources and community programs;
- Make appropriate referrals to address mental health, physical health, and social determinants of health needs;
- Provide Evidence-Based strategies and interventions for population health improvement;
- Provide Evidence-Based chronic medical care, and self-lifestyle management utilizing motivational Interviewing and Stages of Change;
- Link members and community resources effectively;
- Conduct member home and community visits;
- Ensure members attend scheduled appointments in the community and at Health Solutions;
- Maintain competency and proficiency with the agency's electronic health record;
- Maintain accurate records; and
- Perform other job-related duties assigned by the director or designee.
- Physical requirements include the following:
- Frequently stays stationary for prolonged periods of time.
- Frequently moves within and between facilities.
- Frequently exposed to stressful or emergent situations.
- Frequently operates a computer and other office equipment to record health data.
- Constantly communicates with clients and others.
- Occasionally moves equipment and/or materials up to 50 pounds.
- Occasional exposure to communicable diseases and bodily fluids
- Competitive pay $70,940 - $75,669 depending on credentials with the potential for additional compensation based on productivity;
- Generous benefits package. For most positions, includes paid holidays, PTO, EAP, tuition reimbursement, retirement, insurances, FSA, and a premier wellness program
- Insurance: Medical, Dental, and Vision, with low deductibles. Also, Wellness benefits program available.
- HS Funded: EAP, Teladoc, LifeLock, Direct Path, Life and AD&D, LTD
- Retirement 403(b) with employer match up to 6%
- Additional Insurance: FSA, Voluntary Life, Allstate Voluntary benefits
- School age daycare
- Flexible work schedule
- Employee recognitions and celebrations;
- Warm and friendly work environment in which staff respect and learn from one another.
- Associate or Baccalaureate degree in Nursing;
- Current Colorado RN license in good standing
- Colorado driver's license, a good driving record, and access to transportation during work hours.
- Exceptional documentation and computer skills
- Experience successfully working in multi-disciplinary teams;
- Experience working with adults with severe and persistent mental illness;
- Experience providing case management services to adults;
- Community systems navigation background;
- Spanish language skills;
- Certification as a diabetes educator, nutritionist, chronic disease or other specialty is a plus.
- Adapt to change in the workplace and use change as an opportunity for innovation and creativity.
- Take ownership of problems, brainstorm resolutions, use sound judgment in selecting solutions to problems, and then demonstrate consistent follow through.
- Possess the job knowledge and skills to perform the fundamental job functions, and willingly assume greater responsibility over time regarding the scope of work.
- Inspire and model collaborative teamwork; and
- Demonstrate accommodation, politeness, helpfulness, trust building, appropriate boundaries, and flexibility in customer service.
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Registered Nurse - Walsenburg, CO, United States - Health Solutions
Description
Health Solutions is a premier wellness center focused on whole-person care.With over 400 employees in Southern Colorado, you would be joining a mighty team of support and administrative staff, case managers, clinicians, physicians, nurses, and others in our efforts to improve the health and wellbeing of our community.
We're hiring a Registered Nurse to become an Healthcare Coordinator with our Care Coordination team in our rural clinics to include Huerfano and Las Animas counties.
As the Registered Nurse Healthcare Coordinator, you would become a central member of our Care Coordination team's efforts to improve the medical and behavioral health of clients.
You would act as a point person for building professional relationships with medical partners and community agencies, synthesizing data to address client needs, and conducting outreach activities designed to meet the health needs of our community.
Specifically, the RN Healthcare CoordinatorWhat We're Looking For-The Must-Haves
